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SOUTHERN FOX VALLEY

EMERGENCY MEDICAL SERVICES SYSTEM

TITLE: Latex Free Precautions

NUMBER: D 28.0

SECTION: General Policies

PREPARED BY: EMS Administration

DATE REVIEWED: 6/18/14

DATE REVISED: 5/27/09

DATE INITIATED: 6/1/2001

REVISION NO: 1

PAGE: 1 of 3

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A. PURPOSE:

To identify and appropriately treat patients with Latex sensitivities.

B. POLICY:

1. Latex is a natural substance derived from the milky sap of the rubber tree.

2. Latex allergy-is a hypersensitivity to latex. It arises when the immune system reacts to the substance (allergen). An individual may experience a reaction either to the chemical additives used in the manufacturing of the latex products or to the proteins in the latex itself. Persons who develop sensitivity often have a history of hay fever, asthma, eczema, food allergies, or a history of other allergies.

Patients at risk for latex sensitivity include:

1. History of unexplained anaphylactic reaction during surgery, indwelling urinary catheter use, rectal or vaginal or dental procedure.

2. Patients with spina bifida or other congenital spinal abnormalities

3. Patients requiring chronic bladder catheterization

4. History of multiple surgeries

5. Patients with occupational exposure

6. History of multiple allergies

7. Allergies to avocados, bananas, cherries, celery, chestnuts, figs, kiwi, melons, milk, nectarine, papaya, passion fruit, peaches, plums, potatoes, or tomatoes.

Recommendations for EMS agencies and Health Care Facilities:

1. If time permits before loading the patient, the interior of the ambulance should be prepared to minimize latex protein on surfaces.

a. Put latex containing gloves and equipment in closed cabinets.

b. Wipe surfaces with a damp cloth

c. Place clean sheets on the cot and use fresh towels and other linens.

d. Open the side door and the back door to ventilate the patient compartment.

e. If weather permits, transport the patient with the windows open.

2. Wash hands with soap and water or waterless disinfectant solution. If you have previously used latex products, wear a gown to cover clothing. Powder from latex gloves may be on your clothing.

3. Use latex-free equipment in care of the patient.

4. Loosely wrap the patient’s upper arm with Webril before applying the BP cuff or use a latex-free BP cuff.

5. Use a latex-free stethoscope or cover the entire stethoscope tubing with Webril or stockinette.

6. Medications in vials may have a stopper containing latex. Avoid insertion of a needle through the stopper. Remove the metal collar and the “rubber” stopper and draw up the medication.

7. The medication injection port of the IV bag may contain latex. Inject medications into the IV tubing (spike port) before connecting the tubing.

8. When using an OB kit for delivery with a mother allergic to latex, do not use the enclosed sterile gloves (if they contain latex). If the bulb syringe contains latex, cover it with stockinette. The newborn is not sensitive to the latex, but the mother could be affected.

9. Avoid use of the PASG.

10. Do not use the finger of a latex glove as a flutter valve for needle chest decompression.

11. Inform the receiving hospital of the latex sensitivity in the radio report.

12. If a patient has signs or symptoms of latex allergic reaction, follow the Allergic Reaction/Anaphylactic Shock SMO or orders given by medical control.

**Consider latex exposure as a cause of sudden unexplained deterioration in a patient that may have already been diagnosed or is unable to communicate that they have a hypersensitivity to latex products.

Types of Reactions:

There are three common reactions to latex.

1) Irritant Dermatitis-this is NOT an allergy. The powder in the gloves can cause it. Symptoms include localized itching and redness. Treatment is not to wear the powdered gloves that cause this irritation.

2) Type IV Reaction-this is triggered by the chemicals used during the processing of latex. The powder carries these chemicals. This reaction may be delayed for as long as three days. However, the time of exposure to reaction decreases with continued exposure. Symptoms include itching, redness, flushing, edema, coughing, runny nose, and conjunctivitis. Some of these symptoms occur from the powder becoming aerosolized or by the glove wearer touching his/her face. The symptoms resolve when the person has time off from work. This makes the diagnosis very difficult.

3) Type I Reaction-this is an immediate allergic reaction to the latex itself. Mediated by IgE, an immunoglobuliln that plays a role in allergic reactions by attaching itself to mast cells of the respiratory and intestinal tract. The latex proteins bind to these cells and histamine is released.

Because of the different protein antigens in the latex and the degree of an individual’s sensitivity, the symptoms may vary from person to person. Also, an individual’s degree of sensitivity increases with increased exposure. The symptoms may initially be local and then progress to systemic.

Latex-free Supplies

The following supplies MUST be latex-free. If any of the following items on the ambulances are not latex-free, a comparable item that is latex-free should be added to your latex free kits. All future replacement items must be latex-free.

Bag-valve-mask

Oral airways

Oxygen masks

Oxygen nasal cannula

Oxygen tubing

Aerosol masks

Nebulizers

Syringes

Needles

Endotracheal tubes

Stylet

IV catheters

Yankauer rigid suction catheter

Latex-free Kits

The following items will be stocked in a latex-free kit:

Tape, 1 inch paper

Stethoscope

Syringes with needle; 1, 3, and 10 cc

Latex free gloves, sizes M, L, XL

Tourniquet

IV administration set (regular and mini-drip)

Band-Aids

ECG monitoring electrodes

Nasal airways

Webril 4”

Stockinette 4”

Mask/eye shield with ties

Medication labels

Products that Contain Latex

A wide variety of products contain latex: medical supplies, personal protective equipment, and numerous household objects. Most people who encounter latex products only through their general use in society have no health problems from the use of these products. Workers who repeatedly use latex products are the focus of the alert. The following are examples of products that may contain latex:

Emergency Equipment Office Supplies

Blood pressure cuffs Rubber bands

Stethoscopes Erasers

Disposable gloves

Oral and nasal airways Hospital Supplies

Endotracheal tubes Anesthesia masks

Tourniquets Catheters

IV tubing Wound drains

Syringes Injection Ports

Electrode pads Rubber tops of multidose vials

Dental dams

Household Items

Automobile tires Personal Protective Equipment

Motorcycle and bicycle handgrips Gloves

Carpeting Surgical masks

Swimming goggles Goggles

Racquet handles Respirators

Shoe soles Rubber aprons

Expandable fabric underwear/socks

(waistbands etc.)

Dishwashing gloves

Paint, glue

Balloons, tennis Balls, koosh balls

Chewing gum

Condoms, contraceptive sponges, diaphragms

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